Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 177

Bone mass begins to decrease well before menopause in women (as early as the 20s in the femur of sedentary women) and accelerates in the perimenopausal years, with continued declines into late old age. Similar patterns are seen in men, without the acceleration related to loss of ovarian function seen in women. As with losses of muscle tissue (sarcopenia), many factors related to genetics, lifestyle, nutrition, disease, and medication enter into predicting bone density at a given age.

Table 7.5 Exercise recommendations targeting optimal body composition for older adults.

Exercise recommendations	Decreased adipose tissue mass and visceral deposition	Increased muscle mass and strength	Increased bone mass and density and reduced fracture risk
Modality	Aerobic or resistance training	Resistance training	Resistance training
High‐impact activities (jumping using weighted vest during exercise) if tolerated by joints
Balance training
Frequency	Aerobic: 3–7 days/week Resistance: 3 days/week	3 days/week	Resistance training: 3 days/week
Balance training: up to 7 days/week
Volume	Aerobic: 30–60 min/session Resistance: 2–3 sets of 8–10 repetitions of 6–8 muscle groups	2–3 sets of 8–10 repetitions of 6–8 muscle groups	2–3 sets of 8–10 repetitions of 6–8 muscle groups
50 jumps per session for high impacta
2–3 repetitions of 5–10 different static and dynamic balance postures
Intensity	Aerobic: 60–75% of maximum exercise capacity (VO2 max or maximum heart rate) or 13–14 on the Borg Scale of perceived exertion Resistance: 70–80% of maximum strength (one repetition maximum) exertion	70–80% of maximum capacity (one repetition maximum)	70–80% of maximum capacity (one repetition maximum) as load
5–10% of body weight in vest during jumps; jumps or steps of progressive height
Practice the most difficult balance posture not yet mastered

^a Thus far proven only in premenopausal women or when combined with resistance training in older adults.